Holistic Approaches to A Good Night’s Sleep

“I used to be a great sleeper. Now I wake up several times a night and never get a solid 8 hrs of sleep. I fall asleep quickly when I first go to bed and also after waking up each time but waking up about every 2 hours certainly is counterproductive to getting a good night’s sleep! I don’t want to take sleeping pills. I take melatonin, 5HTP, B vitamins with minerals, & calming teas as sleep aids. Could you give us your thoughts on getting a good night’s sleep when over 50.” ~ AK

In my practice I treat many people with sleep issues, hormonal and metabolic imbalances, and adrenal stress. I will address AK’s questions down at the bottom of the blog, after laying the ground work for some of the mechanisms of sleep challenges + solutions.

What happens when we sleep anyway? Here’s what we know:

•Sleep is a time for recharging the brain.

•Sleep gives the brain an opportunity to reorganize data to help find a solution to problem, process newly learned information and organize and archive memories.

•We detox while we sleep! The liver’s complex enzyme system breaks down and excretes carcinogens and other waste materials overnight.

•Bones remodel. How cool is that! The body has a chance to replace chemicals, repair muscles, and do bone repair which protects us from osteopenia + osteoporosis.

•Growth hormones are released while we sleep, which helps children and young adults grow.

As you can see, the cost of poor sleep is much greater than many people think ~ and may have profound consequences for our long-term health. These include lowered immunity with increased susceptibility to infections, impaired glucose tolerance, low morning cortisol levels, and increased carbohydrate cravings

Sleep and hormones:

Women tend to have more sleep disturbance issues than men, and this is often related to hormonal imbalances (from peri-menopause through menopause), including disorders of thyroid hormone, estrogen, progesterone, testosterone, cortisol, and growth hormone which can all cause sleep disorders. Detecting a subtle endocrine imbalance may sometimes be difficult to analyze on your own, requiring the guidance of a knowledgeable health practitioner. As a clinician, I’m here to help my patients navigate this passageway naturally.

Modern life: Do you live in Go-Mode?

These days we are all likely to multi-task and move too fast – too often. That’s very difficult for our mind and body! Physiologically, we are meant to respond to life’s input, take action, and return to a stable state of equilibrium known as “homeostasis”.

Here is a list of behaviors that result in “Go Mode” (also known as Sympathetic Dominance) & contribute to sleep disturbances, as excerpted from Tired of Being Tired by Jesse Lynn Hanley, MD:

Skipping meals

Eating processed/junk food

Not exercising or over-exercising

Neglecting relaxation and calming activities

Neglecting fun activities that clear your mind

Pushing past your fatigue to complete projects

Shallow breathing, especially when tense

Putting yourself last

In daily life, this includes –

“adrenalizing” our nervous system with high (or any) caffeine intake and “taxing our liver” with alcohol, medications or environmental stressors (including xenoestrogens) … as all can contribute greatly to sleep challenges.

our personal and collective lack of mind calming in today’s hyper and often stroboscopically-drenched media world. As we age, we definitely can benefit from building in regular periods of mindfulness – whether sitting to meditate, walking meditation or simply quieting the mind and being fully present.

A Chinese Medicine View of Sleep & Sleep Disturbances:

Worry/Overthinking – Do you ruminate? Not let go of old stories or current worries?

Overwork: working long hours without adequate rest or under harsh conditions combined with irregular diet, excessive sexual activity ~ we believe these all weaken the Kidney yin (think of adrenal fatigue).

Anger, Frustration, Resentment, Irritability ~ all are frequently signs of Excess Liver stagnancy which may lead to trapped heat disrupting our calm.

Timidity/Fear/Indecisiveness ~ are often signs of imbalanced gallbladder stress.

Irregular Diet ~ seen as over-eating, eating too quickly or on the go, eating heavy, carby, processed and/or spicy foods ~ which can lead to an over-taxed and depleted digestive system which we describe as Spleen Qi Deficiency leading to Dampness.

Supplements to Consider:

Magnesium glycinate or citrate – 200-400 mg (higher levels are fine, and even these levels can cause looser bowels which is not a problem, but a normal side effect). Magnesium supports 300 enzymatic functions, including relaxing muscles, reducing stress on the adrenals and nourishing the heart.

L-Theanine is a derivative of green tea which supports calming alpha brain waves, without causing drowsiness. 200 mg is a good dosage.

Phosphatidylserine (PS) – for high nighttime cortisol (testing is recommended to confirm you have this pattern). 50 mg is a typical dosage, and you may require more, depending on your pattern. I like “Cortisol Manager” by Integrative Therapeutics, which contains PS, L-Theanine and herbs, including Ashwagandha, and a standardized extract of Magnolia bark.

Melatonin – 1 mg – 3 mg is typically enough. You may not have low levels, though, which is where testing helps.

GABA – I usually recommend GABA precursors (this includes L-Theanine), and discuss using this with patients who are a good fit. It may be in a sleep “blend” which is fine.

5-HTP, a natural amino acid and metabolic intermediate in the biosynthesis of serotonin and melatonin from tryptophan. 100 mg is the common dosage for sleep support. It is used for mood support at higher dosages.

How we eat, how much, and how often:

One of the best habits you can have is to maintain balanced blood sugar levels, which usually means eating something healthy every few hours, such as good fats, proteins, or fiber.

Our bodies consider low blood sugar a stressor (think survival threat) and, as a result, releases the hormone cortisol, which raises our blood sugar and stimulates the nervous system. Consider eating a balanced bedtime snack, which includes complex carbohydrates, such as brown rice that has a calming and soothing effect on the nervous system and the mind. Complex carbohydrates also boost serotonin, which promotes better sleep. Along with the complex carbohydrates mentioned above, I recommend:

Mushrooms (all types ~ cooked, not raw)

Walnuts, hazelnuts and sunflower seeds – promote serotonin

Hummus

Small amounts of fruit, especially mulberries and goji berries which calm the mind

Other Nighttime Rituals:

Take am Epsom salt bath with aromatic essential oils such as lavender or rose

Avoid stimulating activities at night such as reading on your iPad, Tablet or Kindle, staying on your computer or watching television just before bed which can raise your cortisol and disturb your pineal gland’s melatonin levels

Read something beautiful, meditate or simply quiet your mind and set your intention for a peaceful night’s sleep and a restful day ahead

AK – from what you’ve shared, I would suggest taking any B-vitamins (if being taken on their own) in the morning, as B-vitamins can be energizing. Some supplement blends will add B-6 to support mood in nighttime formulas, which is fine. Otherwise, use these in the morning. I would suggest trying some of the recommendations above if some are new to you. Clinically, consider running a comprehensive hormone panel to learn more about your estrogen, progesterone, and testosterone patterns and your cortisol rhythm throughout the day and night. For more information on this testing, offered through my clinic, click here. I hope the above information offers you more tools to explore a restful night’s sleep.